Organization · Type 2 NPI

Providence Health & Services - Wa

General Practice Physician · Mukilteo, WA

NPI number 1003050709 Active

Practice location

4112 Harbour Pointe Blvd SW, SUITE100
Mukilteo, WA 98275-5457

Call (425) 347-6350 Map

Fax (425) 347-6335

Mailing address

PO Box 34439
Seattle, WA 98124-1439

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000XNone listed
Internal Medicine Physician 207R00000XNone listed
Pediatrics Physician 208000000XNone listed
General Practice Physician Primary 208D00000XNone listed
Durable Medical Equipment & Medical Supplies 332B00000XNone listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

10 other providers at this address

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About NPI 1003050709

Providence Health & Services - Wa's National Provider Identifier is 1003050709, issued on Apr 24, 2009. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Mukilteo, WA. The record was last updated on Jul 25, 2025.